Qiu Xianben, Yang Jie
Department of Otolaryngology, Head and Neck Surgery, Hanchuan People's Hospital, Hanchuan, China.
J BUON. 2018 Jul-Aug;23(4):1111-1117.
To observe the efficacy and side effects of cetuximab combined with radical radiotherapy in the treatment of sinonasal squamous cell carcinoma (SCC), and to investigate the underlying mechanism of cetuximab.
62 patients with locally advanced sinonasal SCC diagnosed in our hospital from January 2013 to January 2014 were enrolled. Cetuximab and radical radiotherapy were simultaneously given to patients in the combination group, while only radical radiotherapy was given to patients in the radiotherapy group. Cetuximab was administered weekly until the end of radiotherapy. Patients intolerant to cetuximab or withdrawn the informed consent were excluded. On first administration, cetuximab was given i.v. at a dose of 400 mg/m for more than 120 min, with maximum drop rate of 5 mL/min. Afterwards, cetuximab was given i.v. per week at a dose of 250 mg/m for more than 60 min.
(1) The objective response rate (ORR) and disease control rate (DCR) in the combination group was 77.42% and 93.54%, respectively, while the ORR and DCR in the radiotherapy group were only 45.61% and 70.97%, respectively (p<0.05). (2) The progression free survival (PFS) and the median overall survival (OS) in the combination group were 19.5 and 26.6 months, respectively, while in the radiotherapy group were only 13.8 and 18.9 months, respectively (p<0.05). (3) The incidence of rash in the combination group was significantly higher than that of the radiotherapy group (p<0.05). However, there were no significant differences in other adverse reactions between the two groups.
Combination of cetuximab with radical radiotherapy is safe and effective for advanced local sinonasal SCC and improves the survival rate and the prognosis of patients with sinonasal SCC.
观察西妥昔单抗联合根治性放疗治疗鼻窦鳞状细胞癌(SCC)的疗效及副作用,并探讨西妥昔单抗的潜在作用机制。
选取2013年1月至2014年1月在我院确诊的62例局部晚期鼻窦SCC患者。联合组患者同时接受西妥昔单抗和根治性放疗,而放疗组患者仅接受根治性放疗。西妥昔单抗每周给药,直至放疗结束。排除对西妥昔单抗不耐受或撤回知情同意书的患者。首次给药时,西妥昔单抗静脉滴注,剂量为400mg/m²,持续120分钟以上,最大滴注速度为5mL/min。此后,西妥昔单抗每周静脉滴注,剂量为250mg/m²,持续60分钟以上。
(1)联合组的客观缓解率(ORR)和疾病控制率(DCR)分别为77.42%和93.54%,而放疗组的ORR和DCR分别仅为45.61%和70.97%(p<0.05)。(2)联合组的无进展生存期(PFS)和中位总生存期(OS)分别为19.5个月和26.6个月,而放疗组分别仅为13.8个月和18.9个月(p<0.05)。(3)联合组皮疹的发生率明显高于放疗组(p<0.05)。然而,两组之间其他不良反应无显著差异。
西妥昔单抗联合根治性放疗治疗局部晚期鼻窦SCC安全有效,可提高鼻窦SCC患者的生存率和预后。